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At least 19 recordsLinked to original sources
PubMed1987

Pyogenic liver abscess.

Liver abscess is an uncommon condition, with an incidence of one to four cases per year in most hospitals in the United States. It can affect persons of any age but is most commonly seen in patients 50 to 70 years old. Clinical findings are nonspecific in a large number of patients and, therefore, one should maintain a high clinical index of suspicion and be aware of abnormal laboratory data, particularly liver function tests. On the basis of these factors, one of the imaging techniques discussed earlier--particularly the ultrasound and the CT scan--should be ordered for the patient immediately. Once the diagnosis of liver abscess is made, the primary source of infection should be determined. Prompt antibiotic treatment and percutaneous drainage or open surgery, depending on the circumstances, should be used. This approach should minimize the morbidity and mortality in this disease that was otherwise always fatal just a few decades ago.

Female↗
PubMed1989

Resolution of liver abscesses: comparison of pyogenic and amebic liver abscesses.

To examine the resolution of liver abscesses, a prospective ultrasonographic follow-up study was conducted in 51 patients, each with a solitary abscess (26 pyogenic and 25 amebic) which had been treated successfully by non-surgical measures. The rate of complete abscess resolution for each of the initial 6 months was 0%, 5%, 10%, 23%, 30%, and 30% in the amebic group; and 20%, 54%, 77%, 89%, 94%, and 94% in the pyogenic group. The absorption volume of the pyogenic group in the first month was also greater than that of the amebic group (3.0 +/- 5.0 ml/day vs. 1.1 +/- 0.8 ml/day, P less than 0.05). The resolution ratio of pyogenic and amebic liver abscesses in the first month was 74% +/- 38% and 36% +/- 23%, respectively. In 3 patients in the amebic group, the abscess was still detectable 2 years after treatment. These results suggest that pyogenic liver abscesses resolve more rapidly than amebic abscesses. These findings should be considered in the differential diagnosis of asymptomatic space-taking lesion in the liver.

Actuarial Analysis↗
PubMed1989

Pyogenic and amebic liver abscess.

Amebic liver abscess is more common than pyogenic liver abscess on a global scale. In the United States, pyogenic liver abscess is more frequently seen. The epidemiology, etiology, microbiology, clinical features, natural history, diagnostic studies, and treatment of pyogenic and amebic liver abscess are discussed.

Adult↗
PubMed1985

Amebic liver abscess: a study of 11 cases compared with a series of 38 patients with pyogenic liver abscess.

Amebic liver abscess is an uncommon disease in the northern states of North America with 11 cases seen among approximately 500,000 Mount Sinai Hospital admissions over a 16-year period. Five of 11 cases originated in, or had recently visited South America. In three of these, and two patients with concomitant intestinal amebiasis, the diagnosis was suspected on admission. Diagnosis after admission was rapid, mean 5 days, compared with a mean of 13 days in pyogenic liver abscess. There was a higher incidence of male patients, nine males versus two females which was greater than the excess found in our pyogenic abscesses, 22 versus 16. Multiplicity was less common than in pyogenic abscess, 27 versus 50%, respectively. All three patients with multiple abscesses survived with surgical drainage and antibiotic therapy despite numerous complicating factors, including secondary bacterial infection. One patient resolved with drug treatment only; all others were treated with drugs and concomitant drainage; surgical drainage in earlier cases, and percutaneous drainage more recently. There was a single postoperative death. Drug treatment is the first therapeutic modality, and if recovery is delayed more than 2 days percutaneous aspiration should be carried out. This was successful in four cases. Surgery should seldom be required with present methods of accurately localizing amebic liver abscess, but is essential for ruptured abscess with peritonitis, and liver abscess with associated intestinal problems such as toxic megacolon, colonic perforation, or fulminating colitis. There has been a significant reduction in mortality of amebic liver abscess over the past 50 years and particularly within the past decade.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Tuberculous liver abscess.

Tuberculous liver abscess is uncommonly seen in our experience. We report a case of a 17-year-old boy who presented with typical clinical features of liver abscess, where a diagnosis of tuberculous liver abscess was made on laparotomy and biopsy of the abscess wall.

Adolescent↗
PubMed1979

Liver abscess.

A liver abscess may occur secondary to an umbilical vein catheterization or infection in other parts of the body, and is associated with immune deficiencies, especially chronic granulomatous disease. There are no specific signs and symptoms, but an unexplained fever with upper abdominal tenderness and an enlarged liver were present in all of our cases. A liver-spleen scan is the most useful diagnostic test, demonstrating a filling defect in the liver. A single abscess may be unroofed and drained. When multiple abscesses are found, as many as possible are drained, but long-term specific antibiotic therapy is the most important treatment.

Child↗
PubMed1989

[Percutaneous drainage treatment of primary liver abscesses].

28 primary liver abscesses, including 9 amoebic abscesses, in 24 patients were drained percutaneously. Indication for drainage in amoebic abscesses was imminent rupture and clinical symptoms as pleural effusion, lung atelectasis and pain. 95% of the primary abscesses were cured by percutaneous drainage and systemic antibiotic treatment. There was one recurrence of abscess, which was managed surgically. Reasons for drainage failure were: tumour necrosis and tumour perforation with secondary liver abscess.

Adult↗
PubMed2025

Genomic prediction and genome-wide association study for liver abscesses in crossbred beef cattle.

Liver abscesses are a concern in feedlot cattle, and little is known about the role of genetics in their development. This study aimed to estimate genetic parameters and to identify single-nucleotide polymorphisms (SNPs) associated with liver abscesses. Crossbred cattle representing 18 breeds in the U.S. Meat Animal Research Center Germplasm Evaluation Program were phenotyped for liver abscesses at slaughter (n&#x2005;=&#x2005;9,044). Seventeen percent of cattle had liver abscesses. These cattle had genotypes that were imputed to sequence variant genotypes. After filtering and quality control, 340,723 SNPs were used in the analysis. Liver abscess prevalence was modeled with a single-step genomic best linear unbiased prediction (ssGBLUP) threshold model using a Bayesian framework. The model included contemporary group (sex, treatment group, and slaughter date), additive genomic, and residual effects. Genomic heritability was 0.039 (95% highest posterior density&#x2005;=&#x2005;0.005, 0.081), which was very small. To assess prediction quality, a 5-fold random cross-validation structure was used. Method Linear Regression was used to assess accuracy, bias, and dispersion by comparing estimated breeding values (EBV) from full and reduced analyses. Cross-validation metrics showed EBV based on genotypes had 0.05 reliability (SD&#x2005;<&#x2005;0.01) with no bias relative to EBV based on genotypes and phenotypes. For the genome-wide association study, SNP effects were back calculated from the EBV solutions from ssGBLUP. No SNPs were associated with liver abscesses at a Benjamini-Hochberg adjusted 0.05 significance level. Although a large dataset was used, this result was because of the low genomic heritability and imprecise EBV used to calculate SNP effects. Based on these results, environmental factors contribute to most of the variation in liver abscesses. Genetic selection to reduce liver abscesses would be slow because of the low genomic heritability, measurement late in life, and inability to measure breeding animals. A faster approach would be finding additional environmental interventions that maintain animal performance.

Animals↗
PubMed1989

Liver abscesses.

Clinical suspicion of a liver abscess mandates an investigation of the liver for evidence of a liver abscess by radionuclide, ultrasound, or CT scan. Amebic abscesses have a lower mortality rate than pyogenic abscesses. Amebic and pyogenic abscesses can be distinguished on the basis of epidemiologic, clinical, and laboratory studies. The definitive studies for identifying amebic liver abscesses are hemagglutinin or gel diffusion studies. Amebic abscess of the liver may be complicated by extension to the lung, with pulmonary complications. Patients suspected to have amebic abscesses require metronidazole. Emetine or chloroquine may be added if there is no response or if the abscess recurs. Unless there is a failure of the amebic abscess to resolve or secondary infection occurs, there is seldom a need to aspirate or drain these abscesses. Pyogenic abscesses should be treated with broad-spectrum antibiotics to cover gram-negative aerobes and anaerobic organisms. All pyogenic abscesses larger than 1.5 cm in diameter should be aspirated, and the aspirate should be Gram stained and cultured. Percutaneous or surgical drainage should then be performed. Operative intervention is required in those patients with intra-abdominal pyogenic infections that are seeding the liver abscess. The marked reduction in the mortality rate of pyogenic liver abscess witnessed in this decade is multifaceted and attributable in part to earlier diagnosis, permitting definitive treatment in a timely fashion, as well as to improved intensive unit care, antibiotic management, and operative technique.

Adult↗
PubMed1992

[Liver abscess formation after treatment of liver cancer by arterial injection using adriamycin/mitomycin C oil suspension (ADMOS)].

Of 210 patients with hepatocellular carcinoma (n = 135), metastatic liver cancer (n = 71) and cholangiocarcinoma (n = 4) who underwent intra-arterial infusion of adriamycin and/or mitomycin C oil suspension (ADMOS) and cisplatin, and both regimens, pyogenic liver abscess occurred in seven (3.3%). The percentages of abscess formation in the respective types of liver cancer were 0.8, 7.0 and 25%. These differences among the three types of liver cancer were attributed to the volume of the tumor vascular beds to be embolized, which might determine the relative amount or regional Lipiodol retention in the tumor and normal liver tissue. Four of seven patients with hepatic abscess had received the intra-arterial infusion of ADMOS, and their angiographic findings showed sequential decreases in the vascular beds of the tumor in comparison with those of previous infusion procedures; all had hypovascular liver tumors angiographically. We have never experienced this complication in other treatments such as embolization of the hepatic arteries and intra-arterial infusion of water-soluble anticancer drugs alone. These results suggest that the most important factor leading to abscess formation is the ischemic destruction of the intrahepatic ducts secondary to occlusion of the peribiliary arterial plexus by Lipiodol and/or the direct effects of anticancer drugs on these vessels. To avoid this complication, the volume of Lipiodol used for intraarterial infusion therapy should be carefully determined, especially when the patient has hypovascular tumors of the liver and a history of multiple previous intraarterial infusion procedures of anticancer drug. The use of ADMOS should be avoided in patients with hypovascular tumors of the liver such as secondary deposits and cholangiocarcinoma.

Adenoma, Bile Duct↗
PubMed1992

[Biliogenic liver abscess caused by acute obstructive suppurative cholangitis].

Biliogenic liver abscess was found by autopsy in 52 of 61 (85.2%) cases died of acute obstructive suppurative cholangitis (AOSC) at our hospital from 1957 to 1980. Of the 52 cases with liver abscess, 44 (84.6%) had multiple abscesses and 47 (90.4%) suffered complications of the rupture of liver abscess. Liver abscess was clinically diagnosed in only 7 of 52 cases who underwent emergency operation, with the predeath definite diagnosis of 13.5% (7/52). The authors considered biliogenic liver abscess an inevitable outcome not an accidental complication of AOSC when the high pressure in bile duct could not be relieved, and emphasized the importance of prevention, early diagnosis and treatment of liver abscess in order to decrease the mortality of AOSC.

Acute Disease↗
PubMed1978

Endoscopic retrograde cholangiography (ERC) in nonamebic liver abscesses.

Two cases of liver abscess are reported in whom the diagnosis was suggested by a combination of liver scanning, ultrasonography, arteriography, and liver biopsy. The diagnosis was confirmed by ERC which showed intrahepatic extravasation of contrast from the biliary tree, a characteristic of liver abscess. The value of ERC in the search for an underlying cause as well as in delineating certain features of the absceses is shown.

Adolescent↗
PubMed1992

Percutaneous catheter drainage of amoebic liver abscess.

Fifteen patients with amoebic liver abscesses underwent percutaneous catheter drainage under ultrasonographic guidance. Thirteen patients had solitary abscesses (right lobe 12, left lobe 1), two had associated subdiaphragmatic collections, while two patients had multiple abscesses. The indications for the drainage included lack of response to medical therapy: imminent rupture in five cases; ruptured liver abscesses in three; enlarging abscesses after hospitalization in three; persistent symptoms in two; and large left lobe abscesses in two. The volume of the abscesses before drainage was 102-1008 ml (mean 432 ml). Pigtail catheters (8 F) were used in nine of the patients and 12 F sump catheters in six. When multiple abscesses and associated subdiaphragmatic collection were present, each was drained separately. The catheters were removed (mean 7 days, range 3-20 days) when patients became apyrexial, catheter drainage was less than 10 ml in 24 h and cavitogram showed a negligible cavity (mean residual volume 5.5 ml, range 3-15 ml). Complications included minor blood loss through the catheter for 12 h in one patient and reappearance of the abscess in another requiring further drainage. Our experience suggests that catheter drainage of amoebic liver abscesses in selected cases is safe and effective, and results in prompt and early resolution of the abscess cavity with restoration of normal parenchyma.

Adolescent↗